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VIRTIČ POTOČNIK T, KLEMENC-KETIŠ Z. Perception Of Patient Safety Culture At The Primary Care Level: The Case Of The Community Health Centre Ljubljana. Zdr Varst 2024; 63:21-29. [PMID: 38156339 PMCID: PMC10751894 DOI: 10.2478/sjph-2024-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
Background Patient safety is a crucial element of quality healthcare, and endeavours to enhance it are vital for attaining universal health coverage and improving patient outcomes. This study aimed to evaluate the perception of patient safety culture among staff at the Community Health Centre Ljubljana (CHCL). Methods A cross-sectional study was conducted in December 2022. All CHCL staff (N=1,564) from different professional groups were invited to participate in an anonymous electronic survey using the validated Slovenian version of the "Medical Office Survey on Patient Safety Culture" (MOSPSC). Mean percent positive scores for all items in each composite were calculated. Results The final sample included 377 participants (response rate, 24.1%), most of whom were women (91.5%, N=345) with different professional profiles. The mean age of the participants was 44.5 years (SD 11.1) with a mean work experience of 20.1 years (SD 12.1). The percentage of positive overall MOSPSC composite scores was 59.6%. A strong patient safety culture perception was identified in the following dimensions: Information exchange with other settings (93.5%), Organisational learning (90.2%), List of patient safety and quality issues (88.1%), Patient care tracking/follow-up (76.2 %) and Teamwork (75.0%). Weak patient safety culture was identified in the dimensions of Work pressure and pace (10.7%), Leadership support for patient safety (27.1%), Communication openness (40.9%), Office processes and standardisation (48.2%) and Overall ratings on quality and patient safety (49.4%). Conclusions CHCL leadership should address weaknesses, redesign processes, and implement strategies to reduce patient safety incidents. Establishing a just culture that encourages employees to report errors fosters transparency and facilitates learning from errors.
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Affiliation(s)
- Tina VIRTIČ POTOČNIK
- Community Health Centre Ljubljana, Primary Healthcare Research and Development Institute, Metelkova 9, 1000Ljubljana, Slovenia
- University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska 8, 2000Maribor, Slovenia
| | - Zalika KLEMENC-KETIŠ
- Community Health Centre Ljubljana, Primary Healthcare Research and Development Institute, Metelkova 9, 1000Ljubljana, Slovenia
- University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska 8, 2000Maribor, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, 1000Ljubljana, Slovenia
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Ming Y, Meehan R. Patient Safety Perception Within Hospitals: An Examination of Job Type, Handoffs and Information Exchange, and Hospital Management Support. J Patient Saf 2023; 19:369-374. [PMID: 37144891 DOI: 10.1097/pts.0000000000001128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVES The study has 3 aims: (1) to assess to what extent a person's job role relates to their evaluation of patient safety in the hospital setting; 2) to identify the relationship from hospital management aspects, including level of organizational learning-continuous improvement, level of management support, and level of leader support to patient safety perception in the hospital setting; and 3) to examine the relationship between the rating of the ease of information exchange and clinical handoffs and perceived patient safety in the hospital setting. METHODS This study used a publicly available, deidentified cross-sectional data set from the 2021 Agency for Healthcare Research and Quality's Survey on Patient Safety Culture Hospital Survey 2.0. Welch's analysis of variance and multiple linear regression were used to examine each factor's impact on patient safety rating. RESULTS Supervisors had a higher ( P < 0.001) patient safety perception than people in other job types, whereas nurses had a lower ( P < 0.001) patient safety perception than other job types. Level of organizational learning-continuous improvement ( P < 0.001), level of hospital management ( P < 0.001), level of leader support ( P < 0.001), and ease of handoffs and information exchange ( P < 0.001) were positively related to perceived patient safety. CONCLUSIONS This study highlights the importance of identifying the unique issues affecting nurses and supervisors, different from other job types, that may explain their lower patient safety ratings. Findings from this study suggest that it is critical for organizations to focus on initiatives and policies that promote leadership, management, ease in information exchange and handoffs, and continuous learning.
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Affiliation(s)
- Yue Ming
- From the College of Communication and Information
| | - Rebecca Meehan
- School of Information, Kent State University, Kent, Ohio
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Yoshimatsu K, Nakatani H. Development of a scale measuring home-visiting nurses' attitudes toward patient safety: a cross-sectional study. BMC Nurs 2023; 22:154. [PMID: 37147679 PMCID: PMC10162898 DOI: 10.1186/s12912-023-01288-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 04/03/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Home-visiting nurses are required to recognize risks in their work, ensure patient safety according to the characteristics of home-visiting nursing, and therefore, effectively support stability in patients' lives. In this study, we created a scale measuring home-visiting nurses' attitudes toward patient safety and examined its reliability and validity. METHODS A total of 2,208 home-visiting nurses from Japan were randomly selected as participants. From the 490 responses collected (response rate: 22.2%), 421 responses with no missing values, other than those related to participants' basic information (valid response rate: 19.0%), were analyzed. Participants were randomly divided into two groups: 210 for exploratory factor analysis (EFA) and 211 for confirmatory factor analysis (CFA). To examine the reliability of the home-visiting nurses attitude scale developed in this study, ceiling and floor effects, inter-item correlations, and item-total correlations were checked. Subsequently, EFA was performed to confirm the factor structure. CFA, composite reliability, average variance extracted, and Cronbach's alpha for each factor were extracted to confirm the factor structure of the scale and the validity of the model. RESULTS The home-visiting nurses' attitudes toward patient safety were measured using 19 questionnaire items related to four factors: "Self-improvement for patient safety," "Incident awareness," "Counter measures based on incident experience," and "Nursing care to protect the lives of patients." Cronbach's α coefficients were 0.867, 0.836, 0.773, and 0.792 for Factors 1-4, respectively. Model indicators were χ2 = 305.155, df = 146, p < 0.001, TLI = 0.886, CFI = 0.902, RMSEA = 0.072 (90% confidence interval 0.061-0.083). CONCLUSIONS From the results of the CFA, criterion-related validity, and Cronbach's α coefficient, this scale is considered reliable and valid and thus, highly appropriate. Therefore, it may be effective at measuring home-visiting nurses' attitudes toward patients' medical safety from both behavioral and awareness aspects.
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Affiliation(s)
- Keiko Yoshimatsu
- Department of Nursing, Faculty of Nursing and Nutrition, The University of Shimane, 151 Nisihayasigi-cho, Izumo-shi, Shimane-ken, 693-8550, Japan.
| | - Hisae Nakatani
- Department of Community and Public Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
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Keyvanloo Shahrestanaki S, Rafii F, Najafi Ghezeljeh* T, Ashghali Farahani M, Amrollah Majdabadi Kohne Z. Concept analysis of patient safety in home care: a hybrid model. BMJ Open Qual 2022; 11:bmjoq-2022-002077. [PMID: 36521926 PMCID: PMC9756164 DOI: 10.1136/bmjoq-2022-002077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/16/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Patient safety in home care is a fundamental and complex concept in nursing. This concept includes a number of challenges in patient care. Studies have shown that there is no clear and uniform definition for this concept. OBJECTIVE The objective of the present study was to analyse patient safety in home care in Iran. METHODS The study was done using a hybrid model at three phases, including theoretical, field work and the final analysis. We searched valid databases including MEDLIN and CINHAL; electronic references including Web of Science, Scopus, Ovid, ProQuest, PubMed and Persian databases including Magiran, IranDoc and SID during 2008-2022, using these Persian and English keywords: Patient Safety, Safety, Home Care Service, Domiciliary Care, Home Care and Home Health Care. A total of 16 articles were searched in the theoretical phase and then analysed by content analysis. In field work phase, nine participants were interviewed (nurse, family and patient) and then the interviews were analysed by the content analysis method. In the final analysis phase, a general analysis of the previous two phases was performed and after determining the attributes, antecedents and consequences, a final definition of patient safety in home care in Iran was presented. FINDINGS Based on different studies, patient safety in home care is a multifaceted concept, which encompasses physical, mental, social and practical dimensions. Evaluation, prevention, participation and commitment to the safety culture are the core features of this concept. The patient care concept depends on the commitment of the involved participants, adequate resources, environmental conditions, support of the involved centres (home care agency, hospital and the insurance), self-efficacy and the ability of the caregivers (nurses). CONCLUSION Defining the concept of patient safety in home care provides a basis for the development of a safe patient care system at home. This concept analysis for patient safety in home care could be a guide for future studies.
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Affiliation(s)
| | - Forough Rafii
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi Ghezeljeh*
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Ashghali Farahani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Desmedt M, Ulenaers D, Grosemans J, Hellings J, Bergs J. Clinical handover and handoff in healthcare: a systematic review of systematic reviews. Int J Qual Health Care 2021; 33:6039082. [PMID: 33325520 DOI: 10.1093/intqhc/mzaa170] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 11/03/2020] [Accepted: 12/11/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The purpose of this systematic review is to appraise and summarize existing literature on clinical handover. DATA SOURCES We searched EMBASE, MEDLINE, Database of Abstracts of Reviews of Effects and Cochrane Database of Systematic Reviews. STUDY SELECTION Included articles were reviewed independently by the review team. DATA EXTRACTION The review team extracted data under the following headers: author(s), year of publication, journal, scope, search strategy, number of studies included, type of studies included, study quality assessment, used definition of handover, healthcare setting, outcomes measured, findings and finally some comments or remarks. RESULTS OF DATA SYNTHESIS First, research indicates that poor handover is associated with multiple potential hazards such as lack of availability of required equipment for patients, information omissions, diagnosis errors, treatment errors, disposition errors and treatment delays. Second, our systematic review indicates that no single tool arises as best for any particular specialty or use to evaluate the handover process. Third, there is little evidence delineating what constitutes best handoff practices. Most efforts facilitated the coordination of care and communication between healthcare professionals using electronic tools or a standardized form. Fourth, our review indicates that the principal teaching methods are role-playing and simulation, which may result in better knowledge transfer to the work environment, better health and patients' well-being. CONCLUSIONS This review emphasizes the importance of staff education (including simulation-based and team training), non-technical skills and the implementation process of clinical handover in healthcare settings.
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Affiliation(s)
- Melissa Desmedt
- Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, Gebouw D, Diepenbeek, Province of Limburg 3500 Belgium
| | - Dorien Ulenaers
- Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, Gebouw D, Diepenbeek, Province of Limburg 3500 Belgium
| | - Joep Grosemans
- Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, Gebouw D, Diepenbeek, Province of Limburg 3500 Belgium.,Faculty of Healthcare, PXL University of Applied Sciences and Arts, Elfde-Liniestraat 24, Hasselt, Province of Limburg 3500 Belgium
| | - Johan Hellings
- Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, Gebouw D, Diepenbeek, Province of Limburg 3500 Belgium
| | - Jochen Bergs
- Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, Gebouw D, Diepenbeek, Province of Limburg 3500 Belgium.,Faculty of Healthcare, PXL University of Applied Sciences and Arts, Elfde-Liniestraat 24, Hasselt, Province of Limburg 3500 Belgium
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The Safety Culture of The Ljubljana Community Health Centre's Employees. Zdr Varst 2021; 60:145-151. [PMID: 34249160 PMCID: PMC8256766 DOI: 10.2478/sjph-2021-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/18/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Patient safety is one of the key aspects of healthcare quality and a serious global public health concern. Patient safety culture is a part of the patient safety concept. In Slovenia, primary care is easily accessible, and for medical care, it serves as a gatekeeper to hospital care. For several years, the quality and safety at the primary healthcare level have been the focus of several studies. The present study aimed to assess patient safety culture among all employees of the Community Health Centre Ljubljana. Methods We conducted a cross-sectional study in 2017 using the Slovene version of “Medical Office Survey on Patient Safety Culture” from the Agency for Healthcare Research and Quality. Mean percent positive scores on all items in each composite were calculated according to a user guide. Results The final sample contained 1021 participants (67.8% response rate), of which 909 (89.0%) were women. The mean age of the sample was 43.0±11.0 years. The dimensions most highly rated by the respondents were: teamwork and patient care tracking/follow-up. The lowest scores came from leadership support for patients’ safety and work pressure and pace. Conclusion Patient safety culture in the Community Health Centre Ljubljana is high, but there are certain areas of patient safety that need to be evaluated further and improved. Our study revealed differences between professions, indicating that a customized approach per profession group might contribute to the successful implementation of safety strategies. Patient safety culture should be studied at national levels.
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